Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in Am.

预防学龄前儿童龋齿：在美国测试独特的服务提供模式。

• 批准号: 8070357
• 负责人: David O Quissell
• 金额: $ 135.11万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8070357
• 关键词: Affect; American Indians; Caregivers; Caries prevention; Child; Communities; Community Workers; Confidentiality; Consent; Contracts; Control Groups; Dental Assistants; Dental Auxiliaries; Dental Care; Dental Hygienists; Dental caries; Doctor of Philosophy; Educational Activities; Effectiveness; Enrollment; Ensure; Evaluation; Fluoride Varnishes; Future; Goals; Hand; Head Start Program; Health Knowledge, Attitudes, Practice; Health Promotion; Health Services; Health behavior; Health education; Home environment; Human Resources; Incidence; Intervention; Measures; Mediator of activation protein; Modeling; NIH Program Announcements; Oral health; Outcome; Outcome Measure; Parents; Pattern; Pilot Projects; Population; Preschool Child; Prevention; Prevention program; Preventive; Protocols documentation; Provider; Qualifying; Randomized; Research; Research Personnel; Reservations; Resistance; Rural; Services; Shapes; Siblings; Specialist; Testing; Time; Training; Varnish; Work; community setting; comparative efficacy; cost; cost effectiveness; design; disorder prevention; health disparity; high standard; member; motivational enhancement therapy; northern plains; prevent; primary outcome; programs; prototype; randomized trial; secondary outcome; tribal community

The goal Of RC3 is to demonstrate the effectiveness of specially trained American Indian (Al) Community Oral Health Specialists (COHS) for delivering a caries prevention program to children enrolled in Head Start programs on a large Al reservation in the Southwest. The specific aims of the project are: 1) to develop a manualized intervention protocol for a caries prevention program delivered by COHS; 2) to implement and evaluate the feasibility and acceptability of a COHS-delivered program of oral health promotion and fluoride varnish (FV), as well as a more traditional FV program delivered by dental assistants; and 3) to compare the two programs in terms of secondary outcomes (caries patterns, cost-effectiveness, dispersion effects), as well as any differences identified by potential moderators and mediators that appear to affect outcomes. Head Start Centers (N=32) in communities across the reservation will be randomly assigned to one of the program conditions. The COHS condition will differ from the VAR condition primarily in that activities will include a proactive approach to working with children and their parents to initiate effective home oral health behaviors, as well as community educational activities. Fluoride varnishes will be provided quarterly in both programs. Children will be followed for two years, with caries assessments by calibrated dental hygienists at baseline, 1 year, and 2 years. The content of the COHS training protocol, which originally was developed in a pilot study that was implemented on a Northern Plains reservation, will be reviewed and revised with community input. This study provides a conservative evaluation of the COHS approach, which is designed to overcome resistance to cultural barriers to accessing established dental care services, and to make preventive services more widely available. Rather than comparing the COHS model with standard, higher cost, professional services, we are making a comparison with low-cost providers who will be deployed in a community setting to provide an intervention that consists primarily of a pharmacotherapeutic service (FV) that has proven efficacy for caries prevention. COHS providers, also low cost personnel, will deliver FV as well, so the central research question is whether a focus on personalized and community oral health promotion provided by someone clearly identified with the community provides a significantly greater effect on caries incidence than a low-cost pharmacotherapeutic prevention program. As questions continue to be raised about new delivery models for populations in rural and other underserved settings, this study will provide important information about the model of a prevention specialist trained in a 4-week program to work for improvement in the oral health of preschool children. It is anticipated that this study will be informed and further shaped by early results from RC1.

RC3的目标是证明经过特殊训练的美洲印第安人（AL）社区的有效性 口腔健康专家（COHS）用于向入学的儿童提供龋齿预防计划 西南部大型AL保留的计划。该项目的具体目的是：1）开发一个 COHS提供的龋齿预防计划的手动干预方案； 2）实施和 评估口服促进和氟化物的COHS分配计划的可行性和可接受性 清漆（FV），以及牙科助手提供的更传统的FV计划； 3）比较 关于次要结果（龋齿模式，成本效益，分散效应）的两个程序， 以及似乎影响结果的潜在主持人和调解人所确定的任何差异。 预订跨社区中的头开始中心（n = 32）将随机分配给其中一个 程序条件。 COHS条件将与VAR条件有所不同，主要是在该活动中 包括一种积极主动的方法，与孩子及其父母一起开始有效的家庭口腔健康 行为以及社区教育活动。氟化物清漆将每季度提供一次 程序。儿童将被遵循两年 基线，1年和2年。 COHS培训协议的内容最初是在 将在北部平原保留地实施的一项试点研究，将进行审查和修订 社区意见。这项研究提供了对COHS方法的保守评估 要克服对获得既定牙科护理服务的文化障碍的抵制，并使 预防服务更广泛。而不是将COHS模型与标准模型进行比较 成本，专业服务，我们正在与将部署在某人中的低成本提供商进行比较 社区环境提供主要由药物治疗服务（FV）组成的干预措施 这对龋齿预防有效。 COHS提供商，也是低成本人员，将提供FV 好吧，因此中心研究问题是关注个性化和社区口腔健康 由社区清楚地确定的人提供的晋升提供了更大的效果 关于龋齿的发病率，而不是低成本的药物预防计划。随着问题的继续 在农村和其他服务不足的环境中提出了新的人口的新交付模型，这项研究将 提供有关在为期4周计划中培训的预防专家的模型的重要信息 用于改善学龄前儿童的口腔健康。预计这项研究将被告知，并且 RC1的早期结果进一步塑造。